Background: The introduction of biological drugs in the management of chronic rhinosinusitis with nasal polyps (CRSwNP) is allowing new and increasingly promising therapeutic options. This manuscript aims to provide a multicenter trial in a real-life setting on Mepolizumab treatment for severe uncontrolled CRSwNP with or without comorbid asthma. Methods: A retrospective data analysis was jointly conducted at the Otolaryngology–Head and Neck Surgery departments of La Sapienza University and San Camillo Forlanini Hospital in Rome. Both institutions participated by sharing clinical information on patients with CRSwNP treated with Mepolizumab. Patients were evaluated before starting Mepolizumab, at six months and at twelve months from the first drug administration. During follow–up visits, patients underwent endoscopic evaluation, quality of life assessment, nasal symptoms assessment, and blood tests to monitor mainly neutrophils, basophils, eosinophils, and IgG, IgA, and IgE assay. Results: Twenty patients affected by CRSwNP and treated with Mepolizumab were enrolled (12 females and 8 males with a mean age of 63.7 years). Sixteen patients (80%) had concomitant asthma. During follow-up, a gradual improvement in nasal polyp score, quality of life and nasal symptoms, assessed by SNOT-22 and VAS and loss of smell measured by olfactory VAS, was found. Regarding blood tests, eosinophils decreased gradually, while other blood parameters showed no statistically significant changes. Conclusions: Mepolizumab has been shown to be effective in the therapeutic management of patients with CRSwNP. Further studies are needed to support our findings and better understand the underlying immune pathways to predict patients’ response to biological treatment in CRSwNP.

Real-life evidence of Mepolizumab treatment in chronic rhinosinusitis with nasal polyps: a multicentric study / Cavaliere, Carlo; Loperfido, Antonella; Ciofalo, Andrea; Di Michele, Loreta; Begvarfaj, Elona; Bellocchi, Gianluca; Bugani, Marcella; de Vincentiis, Marco; Greco, Antonio; Millarelli, Stefano; Plath, Michaela; Sculco, Eleonora; Masieri, Simonetta. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 13:12(2024), pp. 1-13. [10.3390/jcm13123575]

Real-life evidence of Mepolizumab treatment in chronic rhinosinusitis with nasal polyps: a multicentric study

Cavaliere, Carlo
Co-primo
Writing – Review & Editing
;
Ciofalo, Andrea
Secondo
Writing – Review & Editing
;
Begvarfaj, Elona
Software
;
de Vincentiis, Marco
Supervision
;
Greco, Antonio
Supervision
;
Sculco, Eleonora
Penultimo
Methodology
;
Masieri, Simonetta
Ultimo
Conceptualization
2024

Abstract

Background: The introduction of biological drugs in the management of chronic rhinosinusitis with nasal polyps (CRSwNP) is allowing new and increasingly promising therapeutic options. This manuscript aims to provide a multicenter trial in a real-life setting on Mepolizumab treatment for severe uncontrolled CRSwNP with or without comorbid asthma. Methods: A retrospective data analysis was jointly conducted at the Otolaryngology–Head and Neck Surgery departments of La Sapienza University and San Camillo Forlanini Hospital in Rome. Both institutions participated by sharing clinical information on patients with CRSwNP treated with Mepolizumab. Patients were evaluated before starting Mepolizumab, at six months and at twelve months from the first drug administration. During follow–up visits, patients underwent endoscopic evaluation, quality of life assessment, nasal symptoms assessment, and blood tests to monitor mainly neutrophils, basophils, eosinophils, and IgG, IgA, and IgE assay. Results: Twenty patients affected by CRSwNP and treated with Mepolizumab were enrolled (12 females and 8 males with a mean age of 63.7 years). Sixteen patients (80%) had concomitant asthma. During follow-up, a gradual improvement in nasal polyp score, quality of life and nasal symptoms, assessed by SNOT-22 and VAS and loss of smell measured by olfactory VAS, was found. Regarding blood tests, eosinophils decreased gradually, while other blood parameters showed no statistically significant changes. Conclusions: Mepolizumab has been shown to be effective in the therapeutic management of patients with CRSwNP. Further studies are needed to support our findings and better understand the underlying immune pathways to predict patients’ response to biological treatment in CRSwNP.
2024
chronic rhinosinusitis with nasal polyps; surgical polypectomy; intranasal corticosteroids; non-steroidal anti-inflammatory drugs; lysine-acetylsalicylate; diclofenac; ketoprofen; fibroblast; proliferation; biological therapies
01 Pubblicazione su rivista::01a Articolo in rivista
Real-life evidence of Mepolizumab treatment in chronic rhinosinusitis with nasal polyps: a multicentric study / Cavaliere, Carlo; Loperfido, Antonella; Ciofalo, Andrea; Di Michele, Loreta; Begvarfaj, Elona; Bellocchi, Gianluca; Bugani, Marcella; de Vincentiis, Marco; Greco, Antonio; Millarelli, Stefano; Plath, Michaela; Sculco, Eleonora; Masieri, Simonetta. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 13:12(2024), pp. 1-13. [10.3390/jcm13123575]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1712145
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